Rosie ia an osteopath with Swansea Body Kinetics at The Natural Health Service in Page Street Swansea.


This month Rosie offers advice on sciatica

“Thou cold sciatica, cripple our senators, that their limbs may halt as lamely as their manners”

 William Shakespeare, 1564


As you can see, Shakespeare wasn’t amused by sciatica in the slightest. Sciatica is a condition referring to the pain experienced from the entrapment of a nerve root (the nerve as it exits the spine) in the low back. The sciatic nerve is one of the largest nerves in the body and begins as several nerve roots in the low back. It travels from the lower back down to supply the lower limb. This means that irritation or compression of these nerve roots can cause pain in the buttock, down the back of the leg and in to the calf and foot. Often the pain is described as shooting, a deep ache and an intense burning sensation. There may also be weakness, numbness, pins and needles or tingling and difficulty performing certain movements of the leg or foot. Sciatica can present symptoms on one or both sides of the body. According to the National Institute for Health and Care Excellence  (NICE) sciatica is estimated to affect between 12-43% of people throughout their lifetime.

So why do these nerve roots get irritated in the first place? According to NICE disc herniations (slipped discs) are responsible for approximately 90% of cases of sciatica in the UK. However there are a few other reasons that the nerve roots may become impinged including arthritis, inflammation of the facets (joints at the back of the spine) or spinal stenosis (narrowing of the spinal canal).

The sciatic nerve itself can also be impinged throughout its pathway by tight muscles of the legs and buttocks. For example, in some people the sciatic nerve runs directly through a muscle in the pelvis called the piriformis muscle. If this muscle becomes tight it can directly compress the sciatic nerve and give symptoms down the whole leg.

There are certain activities that are known risk factors for causing sciatica. These include strenuous activities such as running or heavy lifting (especially if bending and twisting the body), and using machinery that causes whole body vibration. You can help yourself to avoid developing sciatica in the first place by ensuring that when lifting heavy objects you employ good techniques.

The good news is that a lot can be done to improve sciatica and major interventions such as surgery are not often needed. Non surgical treatment (also known as conservative treatment) often has good results with one study demonstrating that 50% of people improved with conservative care within 10 days, and this increased to 75% of people within 4 weeks1. Sciatica is one of the most common presentations I see in my clinic and I find that most people get better or significantly improve within a few treatments. In order to give the best care possible I conduct a full musculo skeletal and orthopaedic examination in order to pinpoint the underlying cause of the sciatica. I then go on to treat the structures that I feel are causing the pressure on the nerve. This includes techniques to encourage blood supply and therefore healing to the disc/joint/suspected structure. I also use neural flossing techniques (specific exercises targeted towards neural health) and work in conjunction with a yoga therapist in order to get you moving in a way conducive to the health of your joints and the nerves.

References: Van Tulder, M., Peul, W. and Koes, B. (2010) Sciatica: what the rheumatologist needs to know. Nature Reviews. Rheumatology 6(3), 139-145. [Abstract]

For further information or to book an appointment call Rosie on 07540 453280 or visit Natural Health Service, 2 Page Street, Swansea SA1 4EZ Tel: 01792 651717

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